【摘要】 目的 探討乳突根治術(shù)后耳內(nèi)窺鏡換藥與常規(guī)換藥相比是否具有優(yōu)勢(shì)。 方法 2003年3月-2008年10月對(duì)89例共89只耳行開放式乳突根治術(shù)患者按隨機(jī)數(shù)字表法隨機(jī)分為試驗(yàn)組及對(duì)照組，試驗(yàn)組45例45只耳采用耳內(nèi)窺鏡換藥，對(duì)照組44例44只耳常規(guī)換藥；分別觀察試驗(yàn)組和對(duì)照組的干耳人數(shù)及干耳的時(shí)間，計(jì)算干耳率及干耳的平均時(shí)間。 結(jié)果 試驗(yàn)組45只耳中42只干耳，干耳率93.3％；對(duì)照組44只耳中40只干耳，干耳率90.9％。兩組比較差異無統(tǒng)計(jì)學(xué)意義（P gt;0.05）。試驗(yàn)組42例干耳患者平均干耳時(shí)間為術(shù)后（50.8±13.4） d，對(duì)照組40例干耳患者平均干耳時(shí)間為術(shù)后（60.7±12.2） d；兩組比較，差異有統(tǒng)計(jì)學(xué)意義（P lt;0.001）。 結(jié)論 中耳乳突根治術(shù)后耳內(nèi)窺鏡下?lián)Q藥與常規(guī)換藥相比不能顯著提高干耳率，但能有效縮短干耳時(shí)間。
【Abstract】 Objective To evaluate the application of otoendoscope in dressing change after mastoidectomy. Method Between March 2003 and October 2008, 89 patients (89 ears) underwent mastoidectomy in Department of Otolaryngology Head and Neck Surgery, West China Hospital of Sichuan University and in Department of Otolaryngology, Nuclear Industry 416 Hospital of Chengdu. The patients were randomly divided into two groups by simple randomization (trial group and control group). Forty-five patients in the trial group underwent the dressing change under otoendoscope, while 44 patients in the control group under the routine method. The ear drying rate and the ear drying time in the two groups were observed. Results The ear drying rate was 93.3% (42 dry ears)in the trial group, and was 90.9% (40 dry ears) in the control group; the difference between the two groups was not significant (P gt;0.01). The ear drying time was (50.8±13.4) days in the trial group and was (60.7±12.2) days in the control groups; the difference between the two groups was significant (P lt;0.001). Conclusion Dressing change under the otoendoscope after mastoidectomy may not improve the ear drying rate but can shorten the ear drying time.
引用本文： 李宇,鄭虹. 中耳乳突手術(shù)后治療中耳內(nèi)窺鏡的應(yīng)用. 華西醫(yī)學(xué), 2011, 26(4): 565-567. doi: 復(fù)制
| 1. | 徐志文, 唐安洲, 陳陵, 等. 開放式乳突術(shù)腔的處理[J]. 中華耳鼻咽喉科雜志, 2000, 35(2): 153. |
| 2. | 董民聲, 魏桂庭, 鄭立. 洛陽耳鼻咽喉科會(huì)議分組小結(jié)[J]. 中華耳鼻咽喉科雜志, 1978, 13(10): 8. |
| 3. | Premachandra DJ, Woodward BM, Miltin CM, et al. Long-term results of mastoid cavities grafted with cultured epithelium prepared from autologus epidermal cells to prevent chronic otorrhea[J]. Laryngoscope, 1993, 103(10): 1121. |
| 4. | Kang MK, Ahn JK, Gu TW, et al. Epitympanoplasty with mastoidobliteration technique: a long-term study of results[J]. Otolaryngol Head Neck Surg, 2009, 140(5): 687-691. |
| 5. | 方朝新, 許耀東, 區(qū)永康, 等. 膽脂瘤型中耳炎術(shù)后復(fù)發(fā)的或殘留膽脂瘤的原因與分析[J]. 臨床耳鼻咽喉頭頸外科雜志, 2008, 22(3): 583-584. |
| 6. | 秦學(xué)玲, 鄭虹, 魏雪梅. 微創(chuàng)手術(shù)治療中耳炎[J]. 華西醫(yī)學(xué), 2004, 19(3): 368-369. |
| 7. | 楊慧, 鄭虹, 周曉英. 耳內(nèi)窺鏡在耳鼻咽喉科門診的應(yīng)用[J]. 華西醫(yī)學(xué), 2005, 20(1): 95. |
| 8. | Karhuketo TS, Ilomaki JH, Puhakka HJ. Tympanoscope-assisted myringoplasty[J]. J Oto-Rhino-Laryngol Relat Spec, 2001, 63(6): 353-357. |
| 9. | Bowdler DA, Walsh RM. Comparison of the otoendoscopic and microscopic anatomy of the middle ear cleft in canal wall-up and canal wall-down temporal bone dissection[J]. Clini Otolaryngol Allied Sci, 1995, 20(5): 418-422. |
| 10. | 王建洪, 胡珍, 梁傳余, 等. 膽脂瘤型中耳炎乳突根治加同期鼓室成形術(shù)187例療效觀察[J]. 四川醫(yī)學(xué), 2009, 30(5): 685-686. |
| 11. | 張衛(wèi)國, 王晶晶, 張家玲. 慢性化膿性中耳炎早期手術(shù)干預(yù)48例[J]. 陜西醫(yī)學(xué)雜志, 2008, 37(12): 1649-1650. |
| 12. | 劉陽, 孫建軍. 中耳乳突手術(shù)中面神經(jīng)隱窩的處理策略[J]. 中華耳科學(xué)雜志, 2008, 6(3): 270-272. |
- 1. 徐志文, 唐安洲, 陳陵, 等. 開放式乳突術(shù)腔的處理[J]. 中華耳鼻咽喉科雜志, 2000, 35(2): 153.
- 2. 董民聲, 魏桂庭, 鄭立. 洛陽耳鼻咽喉科會(huì)議分組小結(jié)[J]. 中華耳鼻咽喉科雜志, 1978, 13(10): 8.
- 3. Premachandra DJ, Woodward BM, Miltin CM, et al. Long-term results of mastoid cavities grafted with cultured epithelium prepared from autologus epidermal cells to prevent chronic otorrhea[J]. Laryngoscope, 1993, 103(10): 1121.
- 4. Kang MK, Ahn JK, Gu TW, et al. Epitympanoplasty with mastoidobliteration technique: a long-term study of results[J]. Otolaryngol Head Neck Surg, 2009, 140(5): 687-691.
- 5. 方朝新, 許耀東, 區(qū)永康, 等. 膽脂瘤型中耳炎術(shù)后復(fù)發(fā)的或殘留膽脂瘤的原因與分析[J]. 臨床耳鼻咽喉頭頸外科雜志, 2008, 22(3): 583-584.
- 6. 秦學(xué)玲, 鄭虹, 魏雪梅. 微創(chuàng)手術(shù)治療中耳炎[J]. 華西醫(yī)學(xué), 2004, 19(3): 368-369.
- 7. 楊慧, 鄭虹, 周曉英. 耳內(nèi)窺鏡在耳鼻咽喉科門診的應(yīng)用[J]. 華西醫(yī)學(xué), 2005, 20(1): 95.
- 8. Karhuketo TS, Ilomaki JH, Puhakka HJ. Tympanoscope-assisted myringoplasty[J]. J Oto-Rhino-Laryngol Relat Spec, 2001, 63(6): 353-357.
- 9. Bowdler DA, Walsh RM. Comparison of the otoendoscopic and microscopic anatomy of the middle ear cleft in canal wall-up and canal wall-down temporal bone dissection[J]. Clini Otolaryngol Allied Sci, 1995, 20(5): 418-422.
- 10. 王建洪, 胡珍, 梁傳余, 等. 膽脂瘤型中耳炎乳突根治加同期鼓室成形術(shù)187例療效觀察[J]. 四川醫(yī)學(xué), 2009, 30(5): 685-686.
- 11. 張衛(wèi)國, 王晶晶, 張家玲. 慢性化膿性中耳炎早期手術(shù)干預(yù)48例[J]. 陜西醫(yī)學(xué)雜志, 2008, 37(12): 1649-1650.
- 12. 劉陽, 孫建軍. 中耳乳突手術(shù)中面神經(jīng)隱窩的處理策略[J]. 中華耳科學(xué)雜志, 2008, 6(3): 270-272.